Challenges with Ejaculation: Seeking Solutions for Improved Sexual Health

Q: Challenges with Ejaculation: Seeking Solutions for Improved Sexual Health

Xiao Meng： I'm glad to hear that your symptoms have improved; congratulations, and keep up the good work. <br>I have always emphasized that sexual activity is a mutual collaboration and learning experience. <br>It cannot be achieved perfectly through the efforts of just one side.

Difficulty achieving normal ejaculation?

Dear Dr.
Hsu,
Happy New Year! Your previous advice has been very helpful to me, and I am slowly understanding my condition better.
The sensitivity at the glans has significantly decreased, but I still have some issues that trouble me: I feel that my sexual performance with my girlfriend has improved a lot, and she agrees.
However, during oral sex, even though the tingling sensation at the glans has diminished, it is still difficult for my penis to become erect.
It seems that thrusting below the glans is easier for achieving an erection.
There have been two occasions when I took Levitra, and I was able to maintain an erection, which satisfied my girlfriend.
However, after normal intercourse, I still find it challenging to feel the urge to ejaculate.
I often have to rely on manual stimulation to achieve ejaculation.
My girlfriend believes that my past experiences with DIY methods were too intense, and that my nerves require that level of strong grip to feel the sensation of ejaculation.
She thinks that the tightness of the vaginal canal is not as intense as that of the hand, which is why I experience this.
I also think this might be the case, so I am hesitant to engage in intense DIY methods again.
On a positive note, one morning during a holiday, I found that I was quite erect on my own, and I had intercourse with my girlfriend without relying on medication.
However, the issues mentioned above still persist.
I am quite worried about whether I need a special approach to improve my situation.
Are our suspicions correct? What would be the appropriate way to address this? I would like to hear your professional advice.
Thank you.
P.S.
I tried a topical ointment called SS Cream, which is an herbal extract from Korea, but the results were disappointing.
Besides causing a stinging sensation, it did not help with erections (I used it 50 minutes ago).
I feel it was a waste, and I would advise others to use it sparingly (I obtained it through a doctor's prescription).

Xiao Meng, 30~39 year old female. Ask Date: 2004/01/28

Dr. Xu Weikai reply Urology

Xiao Meng: I'm glad to hear that your symptoms have improved; congratulations, and keep up the good work.
I have always emphasized that sexual activity is a mutual collaboration and learning experience.
It cannot be achieved perfectly through the efforts of just one side.
Sometimes, your issues can be improved through other methods, such as changing positions, varying depth, or enhancing vaginal tone (which should be coordinated by both partners).
Regardless of gender, everyone's "sensitive areas" are different.
There are some books available that discuss sensitive zones, which you might find helpful.
Try to communicate your feelings to your partner, letting them know how each part of your body responds; also take note of your partner's bodily reactions, as each area can elicit different sensations.
Through this mutual exploration process, you can better understand each other's bodies (which can also be considered foreplay), leading to a more enjoyable experience.
Focusing solely on prolonging erection time may eventually make sexual activity feel like a chore, leading to monotony and boredom over time.
Keep it up, and I hope the new year brings you new experiences.

Director of Urology, Taitung Hospital, Department of Health, Executive Yuan, Hsu Wei-Kai.

Reply Date: 2004/01/28

More Info

When it comes to sexual health, particularly regarding ejaculation challenges and concerns about sexually transmitted infections (STIs) such as HIV, it's important to approach the situation with a combination of medical knowledge, psychological understanding, and practical strategies.

Firstly, your experience with sensitivity and difficulty achieving erection or ejaculation can be attributed to a variety of factors, including psychological aspects, physical health, and past experiences. It’s not uncommon for individuals who have had intense or frequent self-stimulation to develop a preference for certain sensations that may not be replicated during partnered sexual activities. This can lead to a reliance on specific techniques or stimuli, which might not be present during intercourse, thus affecting sexual performance.

From a medical standpoint, it's essential to consider both physical and psychological factors. If you find that you can achieve an erection with medication like Levitra but struggle without it, this could indicate a psychological barrier or a conditioning effect from previous experiences. It’s crucial to communicate openly with your partner about these challenges, as mutual understanding can alleviate some of the pressure you may feel during intimate moments.

To improve your sexual health and address these challenges, consider the following strategies:
1. Gradual Desensitization: Since you mentioned that your sensitivity has decreased, you might benefit from gradually reintroducing different types of stimulation. This could involve varying the pressure and speed during masturbation or intercourse to help your body adjust to different sensations.

2. Mindfulness and Relaxation Techniques: Anxiety can significantly impact sexual performance. Practicing mindfulness, deep breathing, or other relaxation techniques before and during sexual activity can help reduce anxiety and improve your overall experience.

3. Pelvic Floor Exercises: Strengthening your pelvic floor muscles through Kegel exercises can enhance sexual function and control. These exercises can improve blood flow and sensitivity, potentially leading to better erections and ejaculation.

4. Professional Guidance: Consulting a healthcare provider or a sex therapist can provide tailored advice and support. They can help you explore any underlying psychological factors and offer strategies to enhance your sexual experiences.

5. Avoiding Irritants: As you experienced discomfort from the SS Cream, it’s vital to be cautious with topical treatments. Always consult with a healthcare professional before trying new products, especially those that claim to enhance sexual performance.

6. Open Communication with Your Partner: Discussing your experiences and feelings with your partner can foster intimacy and understanding. This can also help you both explore what feels pleasurable without the pressure of performance.

7. Regular Health Check-ups: Since you have concerns about STIs, including HIV, it’s wise to get regular screenings, especially after any new sexual encounters. Knowing your status and that of your partner can alleviate anxiety and promote safer sexual practices.

In summary, addressing ejaculation challenges involves a multifaceted approach that includes understanding your body, improving communication with your partner, and possibly seeking professional help. Remember that sexual health is a journey, and it’s perfectly normal to encounter bumps along the way. By taking proactive steps, you can enhance your sexual experiences and overall well-being.

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